Power of Attorney, Guardianship, Administrative Orders and Authorised Representative for Medicare 011-40030000

POA, Guardianship Orders and Administration Orders give people, or entities, the legal authority to act on behalf of someone else. The difference between these types of arrangements is the way in which a person has been appointed to act on behalf of another individual.

Authorised Representative arrangements give people the authority to act on behalf of someone else for Medicare purposes but they are not legal documents. See the Authorisation to act on an incapacitated person's behalf for Medicare purposes form (MO050) on the Resources page.

For release of Medicare and PBS claims history information requests under POA see Release of information for Medicare.

Note: POA and Authorised Representative arrangements are not transferable across Services Australia. See the 'Someone to deal with us on your behalf' page on the Services Australia website for specific programme requirements. The Resources page contains a link to this page.

• an individual can appoint someone as a POA to act on their behalf in specified circumstances
• a court or tribunal can appoint someone to act as the legal guardian or administrator of an individual who is unable to manage all or some of their affairs due to accident, illness, disability or mental incapacity

POA, Guardianship Orders and Administration Orders will vary on a case by case basis. This means Service Officers must consider each new document to determine whether it allows a person to do business with Services Australia on behalf of someone else.

Note:

• POA documents sighted must be original or a certified copy of an original
• Advance personal plans in the Northern Territory replaces enduring power of attorney

A POA from one state is acceptable nationwide for the purposes of Medicare, unless the POA clearly states it is restricted to the state of origin. If Service Officers are unsure about a POA document, see the Escalation process for Medicare eligibility.

If a POA is issued from another country, it must be verified and confirmed by an Australian legal entity (lawyer, solicitor etc.). Written advice by the legal entity must state that the POA is acceptable in Australia and must accompany the POA document.

The following is a list of definitions related to POA, Guardianship Orders, Administration Orders and Authorised Representative arrangements:

• POA: a legal document that gives authorisation to a person to make legal, financial, or medical decisions for someone else
• Guardianship and Administration Orders: a legal document created by a court or tribunal appointing a legal guardian or administrator to act on behalf of an individual
• Authorised Representative: arrangements which allow a person to act on behalf of an individual for Medicare purposes who is incapacitated and needs help with Medicare services because of a medical condition
• Public Trustees: Australian Government departments established to provide a range of services to the public in a particular state or territory. The legal entity provides financial and administrative services to those who cannot manage their own affairs under Financial Management Orders (FMO) issued by a court or tribunal
• Attorney: the person authorised to act on behalf of an individual (also called donee)
• Donor: the person who has given the POA, that is, the person for whom another person is acting on behalf of
• Donee: the person authorised to act on behalf of the individual (also called attorney)
• Jointly and severally: attorneys can make decisions together or separately
• Severally: attorneys can make decisions independently of the other attorneys
• Jointly: attorneys must agree on all decisions
• General: valid until the donor becomes incapacitated
• Enduring: valid even if the donor is incapacitated

Where family and domestic violence (including abuse of older Australians) may be a concern, Service Officers must give this consideration when assessing applications to record or update:

• Power of Attorney
• Guardianship
• Administrative Order, or
• Authorised Representative for Medicare

See the Process page for more details.

If family and domestic violence appears to be evident, a referral to the social worker must be made. See Family and domestic violence for more details.

Family and domestic violence is conduct that is:

• violent
• threatening
• coercive or controlling
• intended to cause the family or household member to be fearful
• abuse of older Australians (also known as elder abuse) is a form of family and domestic violence

Family and domestic violence can include, but is not limited to:

• physical violence
• sexual assault and other sexually abusive behaviour
• economic (financial) abuse
• emotional or psychological abuse
• stalking
• serious neglect where there is a relationship of dependence
• verbal abuse
• spiritual or cultural abuse

The attorney (donee) must provide the following:

• an original or a certified copy of the POA document
• the donor's Medicare number
• identification:
• Australian Birth Certificate
• Australian Citizenship Certificate
• Australian Drivers Licence
• ImmiCard
• Valid Australian Passport, or
• Foreign Passport with a current Australian Visa

If the attorney (donee) is unable to provide one of the above documents, see Escalation process for Medicare eligibility.

Note: Identification documents do not need to be certified or verified through the Document Verification Service (DVS). Service Officers must check that the name on the identification document matches the name on the POA.

Documents can be provided:

• by mail
• by email, or
• at a service centre

Service Officers must examine the document to determine:

• POA is not for a specific purpose, such as:
• Health - this refers to medical treatment or a decision made in relation to medical treatment. This does not authorise a person to interact with Services Australia
• Conveyancing - this refers to the sale, purchase, or rental of a property. This does not authorise a person to interact with the agency
• POA is enduring (permanent), general, financial, or limited - usually found on the front of the document
• A general POA may be for specific periods or events and usually has an end date. Note: end dates are recorded by the agency
• Financial POA allows interaction with the agency and generally has no end date
• Attorney/Donee:
• Has expressly consented to act and accepts appointment as attorney/donee. This is found in a signed statement, usually at the back of the POA
• Their signature is witnessed by a third party or in some cases, 2 independent witnesses (cannot be witnessed by the donor)
• Cannot witness the donor's signature
• Donor's signature requires 2 independent witnesses. Note: if there is only one witness and the form only allows for one witness, this is acceptable by the agency

When processing a new POA, relevant details of the POA must be included in CDMS. In particular:

• General POA - do not record an end date unless it is stated in the document
• Enduring POA, Guardianship and Administration Orders - do not record an end date
• Limited POA - record an end date as stated in the document

POA documents do not need to be sighted annually once they are recorded in CDMS. The Sight POA due date field is now obsolete and is not to be completed.

Where the power has been given jointly to more than one attorney/donee, identification for all attorneys/donees must be provided and details of each attorney/donee must be recorded in the POA field in CDMS.

Note: a POA is not valid when the donor is deceased.

Where a POA states it only becomes valid when the donor becomes incapacitated, a letter from a medical practitioner stating the incapacitation must be sighted. If a letter is not provided, the POA details will not be included on the donor's record in CDMS. See Escalation process for Medicare Eligibility.

Where a POA is presented at a service centre, suitably skilled Service Officers can process the POA at point of contact. All other Service Officers should scan all documents, together with a certified copy of the POA into PaNDA, by selecting the Medicare Eligibility Enrolment work type.

See the Process page for details on processing a new POA.

Where Services Australia receives an enquiry from an attorney/donee or entity:

• in person - sight identification of the attorney/donee
• over the telephone - authenticate the donor and attorney/donee

An information message displays on the personal record of the customer if a POA, Guardianship and Administration order is registered in CDMS. The Check POA message alerts the Service Officer to select the entitlement button to access the POA tab.

Confirmation must be checked, by asking if:

• the POA is still operative, or
• the person is still the attorney/donee of the customer

Note: the attorney/donee must provide sufficient details to adequately authenticate the donor and the attorney/donee. Details to be provided to the attorney/donee depends on the type of Power of Attorney in place. See Release of information for Medicare. It is not necessary to sight an enduring POA every 12 months.

For quality assurance purposes, when POA details have previously been recorded in CDMS with a sight POA due date, Service Officers must remove details in the Sight POA due date field.

A POA is not valid when the donor is deceased. Any transactions with the agency after the death of the donor should be conducted by the executor or administrator of the deceased's estate. This applies to all POAs and Guardianship Orders. If the executor has claims for the donor, see Medicare claims for deceased persons.

Guardianship and Administration orders are legal documents that give power to the guardian/s or administrator/s to make decisions on behalf of another person.

Where an individual is unable to manage all or some of their affairs, a court or tribunal can make orders appointing a legal guardian or administrator to manage all or some of their affairs.

A person who has been appointed as an administrator under a Guardianship Order or an Administration Order is treated in the same manner as a person appointed under a POA.

The legal guardian, administrator or manager may be:

• an individual
• two or more people appointed together or separately, or
• a legal entity such as the Public Trustee

The guardian or administrator appointed will need to provide the following:

• an original or a certified copy of the Guardianship or Administration Order
• the customer's Medicare card number
• the guardian or administrators identification:
• Australian Birth Certificate
• Australian Citizenship Certificate
• Australian Drivers Licence
• ImmiCard
• Valid Australian Passport, or
• Foreign Passport with a current Australian Visa

If the guardian or administrator is unable to provide one of the above documents, see Escalation process for Medicare eligibility.

Note: identification documents do not need to be certified or verified through the Document Verification Service (DVS). Service Officers must check that the name on the identification document matches the name on the Guardianship or Administration Order.

Guardianship and Administration Orders must be noted under POA in CDMS.

Service Officers must examine documents to determine if the order:

• is not for a specific purpose that is, health or conveyancing. In this case, the order is not acceptable for agency requirements under POA
• specifies a time period, limitation, or conditions

Requests to store banking details permanently from a guardian must not be recorded in CDMS. See Store, confirm and end date bank account details for Medicare EFT payments.

The Process page contains more details on processing a new order and amending or deleting Guardianship and Administrative Orders.

If a Guardianship Order or Administration Order is presented at a service centre, suitably skilled Service Officers can process the Guardianship or Administration Order at point of contact. All other Service Officers should scan all documents, together with a certified copy of the Guardianship or Administration Order into PaNDA, by selecting the Medicare Eligibility Enrolment work type.

Where an organisation (Public Trustee) is appointed as the legal entity under a Guardianship or Administration Order, the following must be provided:

• evidence of a Guardianship or Administration Order
• a written letter on the legal entity's letterhead which includes the appointed person's Medicare card number, if known

Note: the Guardianship or Administration Order does not need to be certified if it has a seal on the document.

An order remains in force for the time specified in the order, or until it is extended, amended, or revoked by a later order.

The Resources page contains a list of the Public trustee entities in each state or territory.

Where a legal entity such as a Public Trustee has been appointed to manage the affairs of an individual under a Guardianship or Administrative Order, and that individual is enrolled on a Medicare card with other people, the individual must be copied onto a card of their own.

A letter must be sent to the legal entity (for example, Public Trustee) requesting the completion of the Application to copy or transfer from one Medicare card to another form (MS011), for the person for whom they hold Guardianship. The Resources page contains links to the MS011 form and the Pub Trustee Other Person on Card letter.

The guardian/trustee's address is recorded at group (card) level and the personal (customer) mailing address is recorded as the person's mailing address. This allows for the customer to change their address at the personal level if required. This will not cause the group address to change and will not affect the guardian/trustee receiving correspondence.

Customers under a Financial Management or other guardianship orders cannot change bank account details without first consulting with the relevant legal entity. Service officers should seek advice from Local Peer Support (LPS) before updating or storing bank account details. Request to store banking details permanently from a trustee can be recorded in CDMS. See Store, confirm and end date bank account details for Medicare EFT payments.

The Process page contains details on how to record this information.

Note: the Guardianship or Administration Order does not need to be certified if it has a seal on the document.

A person (aged 14 years and over) who is unable to manage their own affairs, make sound decisions or give reasonable instructions, may have an Authorised Representative to act on their behalf for Medicare purposes. Evidence must be given to show the customer cannot manage their own affairs due to their intellectual or physical disability or illness.

Note: if a person already has a Power of Attorney, Guardianship Order or Administration Order, they have the legal authority to act on behalf of the customer. The Power of Attorney, Guardianship Order or Administration Order should be registered (if not already) with Services Australia. A person cannot apply (nor is there any reason to apply) to be an authorised representative if a legal authority is already in place.

Authorised Representative arrangements allow an Authorised Representative to interact with the agency on behalf of a customer as if they were the customer themselves.

To act on behalf of another person for Medicare purposes, an Authorised Representative must be:

• over 18 years of age
• an individual who is a close friend or relation to the customer
• must not be a paid carer from an organisation, institution, or community health service, and
• have evidence the person requires assistance due to a medical condition

Note: the agency allows only one authorised representative per customer.

The authorised representative arrangement can be cancelled by:

• customer request (verbally or in writing)
• authorised representative request (verbally or in writing)
• a power of attorney or supply of another legal document
• Services Australia when the authorised representative is:
• unable to be contacted (for example, mail has been returned from the authorised representative's address and attempts to contact the authorised representative by telephone have been unsuccessful)
• not acting in the customer's best interest (for example, allegations of misuse have been made or the authorised representative arrangement is inappropriate)

The person who is applying to be an authorised representative must provide:

• a completed Authorisation to act on an incapacitated person's behalf for Medicare purposes form (MO050)
• proof of identification
• statutory declaration
• evidence of similar arrangements
• evidence of the customer's medical condition

See each requirement in more detail below.

Documents can be provided:

• by mail
• by email, or
• at a service centre

All document types listed below must be provided:

Proof of identification

The customer must provide one of the following:

• Australian Drivers licence
• Australian or foreign Passport
• Australian Birth Certificate or marriage certificate
• Immicard
• birth certificates issued by the for Northern Territory (NT) with Aboriginal Population Record (APR)

Identification documents must be verified in Medicare Document Verification Service (DVS) Portal before processing the application.

Statutory declaration

The authorised representative must state their relationship with the person and what their existing responsibility is, for example, day to day support, on the statutory declaration.

Evidence of similar arrangement

This can include one of the following:

• a nominee arrangement with a government agency, for example, Centrelink or the National Disability Insurance Scheme (NDIS)
• evidence of an Authorised Representative appointment, for example:
• receiving Continence Aids Payment Scheme (CAPS) on the person's behalf
• My Health Record
• evidence of similar arrangements with another organisation or government agency. For example:
• financial institution, or
• NDIS as a child representative or a parent for children under 18 years of age

Note: for children under 18 years of age, Service Officers can accept a letter from the NDIS that identifies the participant (child) and the parent/child representative's details. If the Service Officer is unsure if the evidence provided is sufficient, refer to Medicare Eligibility Local Peer Support (LPS) who can escalate to Medicare Consumers Program Support.

Evidence of the person's medical condition

This can include one of the following:

• specialist report
• recent assessments of the customer's condition or intellectual function from the specialist, or psychologist, or
• a letter from the treating doctor

The evidence must be dated within the last month and include:

• diagnosing medical professional's name
• provider number
• qualifications
• contact details

The evidence must include an end date when the medical assessment states the customer needs help with Medicare services, and this is likely to be a temporary arrangement.

Details for Authorised Representatives are recorded in CDMS. The Process page contains details for Service Officers on how to add an Authorised Representative.

The Resources page contains a link to the:

• Authorisation to act on an incapacitated person's behalf for Medicare purposes form (MO050)
• Commonwealth statutory declaration, and
• 'Someone to act for you' on the Services Australia website

An authorised person who acts on behalf of another person can delegate their powers. The delegation needs to be evidenced by another acceptable document, for example, a Deed Poll.

Note: requests to delegate powers must be escalated, see Escalation process for Medicare Eligibility.

Service Officers must be aware that if a customer has a POA recorded in CDMS, this does not apply to their Medicare online account. This only gives them the legal right to act on behalf of the customer with Medicare.

There is no Nominated Representative process for Medicare online accounts. If a person is provided access through POA, there is no way of knowing who is using the online account.

All Medicare claims under POA, Guardianship or Administration Order must be lodged manually by submitting a Medicare Claim (MS014) form.

It is a privacy and security breach if a third party is given access to a customer's Medicare online account. See Third party Data Breach.

Release of information for Medicare contains details on:

• third party request for information scenarios
• details of additional supporting documents that may be needed for a
• deceased person, or
• a person incapable of managing their own affairs information request
• summary of the most common types of requests and teams who action requests
• explains the type of requests which are actioned by Information Release Officers